What Does Insulin Pump Do?

Insulin (preferably Rapid acting analogue) is filled in a syringe (Reservoir), and the syringe is kept inside the pump. The syringe is attached to a tube called Infusion set. Infusion set has a cannula at its end, which is inserted in subcutaneous tissue with the help of a needle. Then needle is removed. Now the pump can push the exact amount of insulin that user wants. The pump can deliver small amount of insulin continuously at different rates. It can also deliver larger amount of insulin for a meal. Thus, with programming a basal delivery and on demand insulin delivery, that is, bolus delivery like pancreas, is possible with the help of pump. Thus, the pump delivers insulin in two ways - Basal and Bolus. Basal insulin refers to the steady pumping of small amount of insulin continuously with an option of different basal rate for different time of the day. Bolus Insulin is Insulin to cover Carbohydrates in the meal while the pump user decides its quantity as per meal size and type.

Who Should Use Pump?

Insulin replacement by pump makes life very easy and flexible. Few people have predictable lifestyles. On a particular day a person may leave home early with breakfast, while on the other day he may be late or may get stuck in a meeting or can get caught in a traffic jam etc and meal may be delayed. The insulin pump facilitates tackling of such situations comfortably. The possibilities are as varied. When these things happen to patients on injections, the result is often unnecessary stress. When a person starts "thinking like a pancreas" and thus sets a right basal or modifies it as per situation and takes a correct bolus to cover meal, then this person can easily manage day-to-day changes in lifestyle and can remain in safe glucose range.

Why pump is better for Indian patients?

1. Indian diet has higher carbohydrate content that makes post meal control difficult for patients. Pump is a better option to take care of this problem.
2. Sucrose content, part of many Indian food items, is high. This can be easily taken care of through bolus adjustments by pump.
3. Eating at unpredictable timing is very common and unavoidable in Indian society. These food intakes remain uncovered on Injection therapy leading to high A1c though many fasting and 2hr post meal may not be that high. These situations can be very easily managed with pump.
4. Festivals, marriages, fast etc are very common in Indian culture and during these occasions, it is difficult to manage life with injections while pump makes it a smooth sailing.
5. Many patients of type 1 Diabetes don't disclose their disease due to social stigma. Injection is considered a tough treatment in Indian society. Using pump makes it simpler and acceptable.
6. A related issue is also of marriage of diabetics. However, many of them who have been using the pump therapy have overcome this obstacle too, got married and are leading a normal life.
7. Most Indian patients don't prefer true MSI that is one long acting injection and multiple short acting shots to cover all meals. Pump is a better option for them.

Is pump expensive?

Insulin pump costs nearly 2 lakh Rupees [4000 USD]. It involves a monthly cost of infusion sets which is approx Rs 4,500 per month. Thus, an approximate cost of Rs 70,000 to 1, 00,000 per year is required to manage Diabetes with Insulin pump.
Suppose a patient is unable to have a control over Diabetes and this eventually leads to a complication like kidney failure, he or she would have to spend a lot of money on the treatment of the latter. However, we all know that complications like kidney damage are irreversible while the cost of its treatment is quite high. So if a person chooses to spend on the pump, he can actually avoid health complications related to Diabetes and would actually save cost in the long run. Thus investing in the Pump and managing Diabetes may better help in preventing complications. What looks expensive today would turn out to be more economical in the long term. But most importantly, it keeps a person healthier, says Dr Sunil M Jain, CEO, diabeteshormone.com.